Staged Treatment of Open Talar Extrusion Using a 3D-Molded Antibiotic Cement Spacer and Total Talus Replacement

Talar extrusion is an extremely rare, potentially limb-threatening injury.The majority of talar extrusions are open talar dislocations or fracture-dislocations associated with severe surrounding soft tissue injuries.Arthrodesis, talar reimplantation or total talar replacement are among the three possible methods of surgical treatment.With the development of 3D printing in orthopaedics, treatment options are expanding with the use of custom-made talar spacers and prostheses.We report the case of open talar extrusion with talar head fracture treated with temporary implantation of 3D-molded talar antibiotic cement spacer and subsequent replacement with 3D printed total talar prosthesis.The patient achieved pain-free performance of daily activities, with an AOFAS score of 82 and minimal radiological changes at 3-year follow-up.Therefore, temporary implantation of an anatomic antibiotic cement spacer and subsequent replacement with a custom-made 3D printed talus implant may represent a viable treatment option for patients suffering from open talar extrusion and fracture-dislocation.